Scientific Assessment of the Utility of Universal Newborn Hearing Screening

Otolaryngology| January 01 2002 Scientific Assessment of the Utility of Universal Newborn Hearing Screening AAP Grand Rounds (2002) 7 (1): 5–6. https://doi.org/10.1542/gr.7-1-5 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Scientific Assessment of the Utility of Universal Newborn Hearing Screening. AAP Grand Rounds January 2002; 7 (1): 5–6. https://doi.org/10.1542/gr.7-1-5 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: hearing loss, newborn hearing screening Source: Thompson DC, McPhillips H, Davis RL, et al. Universal newborn hearing screening: summary of evidence. JAMA. 2001;286:2000–2010. Thompson et al undertook this study to identify strengths, weaknesses, and gaps in the evidence supporting universal newborn hearing screening (UNHS) and compare the additional benefits and harms of UNHS with those of selective screening of high-risk newborns. Risk factors for sensorineural hearing loss included admission to a newborn intensive care unit for 2 or more days, craniofacial anomalies, congenital infections, family history of hereditary sensorineural hearing loss, and syndromes associated with hearing loss. The authors searched the MEDLINE, CINAHL, and PsychINFO databases for relevant articles published from 1994 to August 2000. Inclusion criteria for the articles were: controlled and observational studies; reports on the accuracy, yield, and harm of screening using otoacoustic emissions (OAEs), auditory brainstem response (ABR), or both in the general newborn population; and reports on the effects of screening or early identification and treatment on language outcome. Nineteen of the 340 selected articles met inclusion criteria and were analyzed. Data on population, test performance, outcomes, and methodological quality were extracted using prespecified criteria developed by the United States Preventive Services Task Force. The authors used the accumulated data to answer 4 questions: In a mathematical model based on the literature review, the authors estimate that extending screening to low-risk infants would detect 1 additional case before age 10 months for every 1,441 low-risk infants screened, and would result in treatment before 10 months in 1 additional case for every 2,401 low-risk infants screened. With UNHS of 10,000 newborns, 254 newborns would be referred for audiologic evaluation because of false positive second-stage screening test results versus 48 for selective screening, and 1 of these would be falsely diagnosed with PHL at the first post-hospital audiology visit. The authors conclude that modern screening tests for hearing impairment can improve early identification of newborns with PHL but it remains uncertain if UNHS will improve their language in the long term. The most important indicator of the potential benefit of UNHS is the number of additional PHL cases that are diagnosed and treated early. The hypothesis that early intervention is a predictor of language acquisition is plausible but not proven, and studies have not yet clearly established the relative benefit of universal versus selective screening. This study confirms that UNHS could accurately diagnose moderate-to-profound hearing impairment, but also points out that as many as 15% or more of the infants with PHL may be missed by hearing screening. Adapting stricter criteria to reduce the high false positive rate may have increased the false negative rate. This study also confirms that UNHS increases early identification of PHL and may lead to early intervention in children with PHL. The question remains: is the outcome in children with PHL changed by early intervention? The authors suggest that population-based studies should evaluate: (1) whether long-term language outcomes of hearing-impaired children improve as the age of identification decreases; (2) if there is... You do not currently have access to this content.